Dialogue Volume 13 Issue 2 2017 - Page 66

discipline summaries judgment in the areas of Pap screening, use of glucometer, use of otoscope, H pylori screening, ordering diagnostic testing such as mammography, pelvic ultrasound, thyroid ultrasound and abdomi- nal ultrasound, office emergency procedures, peri- odic screening, management of diabetes, chest pain assessment, use of Rourke or developmental record and Ontario immunization schedule. • In 15 out of 23 charts, Dr. Ng’s practice is likely to expose his patients to harm/injury. • In five out of five patients observed, Dr. Ng’s prac- tice may expose his patients to harm/injury. With respect to Dr. Ng’s infection control practice, Dr. Z opined as follows: • Dr. Ng carried out improper reprocessing multi-use equipment and displayed a lack of knowledge of proper reprocessing process. • Once hygiene product was available in his office after the Toronto Public Health investigation, he did not utilize it once during the patient observa- tions on June 8, 2015; he did not manage sharps appropriately; he did not document hepatitis B status properly; he did not manage multi-dose vials properly; he did not have controls for refrigerated items; he did not understand or carry out syndrom- ic surveillance. “Dr. Ng’s clinical practice created a definite risk of harm for patients who attended his office prior to February 27, 2015. The risk was one of transmission of respiratory, enteric and blood borne pathogens, and transmission of multi-drug resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA).The nature of the harm ranged from pos- sible acute infection to colonization with a risk of fu- ture infection. Depending on the pathogen, infection could have caused significant morbidity and even mortality. It is not possible to quantitate the prob- ability of the harm … any patient may have been exposed to harm,” Dr. Z stated. 66 Dialogue Issue 2, 2017 Reasons for Penalty The Committee was informed that Dr. Ng signed an undertaking on February 22, 2016, resigning from the College effective immediately and undertaking to neither apply nor re-apply as a physician to practise medicine in Ontario or in any other jurisdiction after the effective date of the undertaking. The protection of the public is of paramount importance in the well-established principles that govern the selection of a penalty in a disciplinary proceeding. Other principles to be considered are the maintenance of public confidence in the integrity of the medical profession and in its ability to regulate itself effectively in the public interest; specific deter- rence as it applies to the member; general deterrence in relation to the membership as a whole; and, the rehabilitation of the member where applicable. The Committee considered the nature and extent of the findings of professional misconduct in this case. The Committee was shocked and appalled by the filthy and deplorable conditions in Dr. Ng’s office as well as the multiple instances of inadequate infection control procedures. Dr. Ng’s lack of knowledge and judgment in this regard is extreme, and he continu- ally placed his patients at risk of harm in a variety of ways, including from the transmission of respiratory, enteric, and blood borne pathogens. Dr. Ng’s clinic was shut down by Toronto Public Health because of unsanitary conditions. When his clinic was ultimately permitted to reopen, the Col- lege’s re-inspection revealed continuing infection control issues. Dr. Ng had been given a chance to ad- dress his deficiencies in exposing patients to infection but he failed to do so adequately. Dr. Ng’s misconduct and incompetence was not limited to poor hygiene and inadequate infection control at his clinic. Th